ChART Journal 2022 - The Humanities & Arts Journal of the Phoenix Biomedical Campus

Celebrating the Humanities & Arts (ChART) Journal

The Journal of the Phoenix Biomedical Campus

9th Edition

ChArt (Celebrating the Humanities & Arts) The Humanities Journal of the Phoenix Biomedical Campus

Volume 9, 2021-2022 ©Copyright, All Rights Reserved

Celebrating the Humanities & Arts is an interprofessional, peer-reviewed/juried journal devoted to sharing the insights and experiences of the Phoenix biomedical community (students, staff, faculty and patients) through original works of personal expression, including original art, essays, motion media, photography, poetry and prose.

The journal is supported by: The Program for Narrative Medicine & Health Humanities,, Department of Bioethics and Medical Humanism The University of Arizona College of Medicine-Phoenix 435 N 5th St. Phoenix, Arizona 85004

Email: PBC-Journal@email.arizona.edu : E-Journal: www.tinyurl.com/ChARTejournal2022 Website: www.narrativemedphx.com Print Copy: www.Amazon.com 3

Dear Phoenix Biomedical Community, Greetings! We are pleased to present our ninth annual humanities and arts journal. Our mission is to celebrate the diversity of perspectives, ideas and experiences of our campus with you and present both the familiar and extraordinary moments in human experiences.

Representative pieces are drawn from the genres of prose, poetry, photography, painting and motion media. They showcase the many creative and artistic talents of our community.

This print edition is a selection of editor favorites, carefully woven together for your enjoyment. We hope that you feel inspired by the unique perspectives of the authors and artists presented. May these works lead you to a renewed level of commitment to self-expression and artistic exploration, and may your own endeavors create harmony, balance and joy in your life.

On behalf of the editorial board – enjoy!

Jennifer R. Hartmark-Hill, MD, FAAFP Faculty Editor-in-Chief

Meher Rakkar Student Editor-in-Chief

Editorial Board

Erik Garber Tiffany Harmanian Jen Hartmark-Hill Tom Kelly Catherine Lockmiller Amy Martins Sarah Nelson Meher Rakkar Corazón Del Desierto Amber Perry 2012

Special Acknowledgements Dr. Jacqueline Chadwick – With appreciation for support for the founding of this journal Dr. David Beyda, Department of Bioethics & Medical Humanism Chair — With appreciation for ongoing support, and providing our publication a home R. Reichenbach - Cover Art

TABLE OF CONTENTS whole R. Reichenback

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Compassion is a Tree…

Alice Treuth

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Honey in Progress Natalie Nabaty

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Table 13is in Bloom Natalie Nabaty

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The Wildflower Merrion Dawson

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Pieces Brady Anderson

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Letting Go Megan Cadigan

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Choice Blake Feldmar

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Which one is the real medical emergency?

Natalie Nabaty

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Health Equity Is and Is Not Alice Treuth

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Melanin Marcus Childs

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His Arms (And Hers) Are Outstretched Still Bailey Adams

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Welcome Sign Catherine Lockmiller

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Who We Are Lisa Shah-Patel

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Dance as One Catherine Lockmiller

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Spring Break Art: Love Galore I Came Here to Love You Forgiveness Erik Garber

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Silence Blake Feldmar

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the white walls Brady Anderson

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Flocked Keepers Elle Maureen Newcome

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Moon at Dusk Melanie Calderwood

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Clouds at Sunset Melanie Calderwood

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Morning Corn Melanie Calderwood

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The Physician’s Fix Adina Greene

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Vaccine Megan Cadigan

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taken Brady Anderson

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Home Dara Farhadi

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Fi(ve)al Hours Ruth Franks Snedecor

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Inner Peace Adolpho Navarro

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The Big Decision Susan Kaib

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Tree Lisa Shah-Patel

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Resolution Joan Frances C. Chua

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Tidal Joy Catherine Lockmiller

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Title: whole Knowing the body is central to caring for patients. We are taught to identify pathology by comparing to a baseline – “normal” anatomy, “normal” physiology, “normal” movement. But what, really, is a “normal” body? This piece interrogates not bodies per-say, but rather corporeality. It challenges the viewer to see not only what is missing, but to see the way in which absence makes space for wholeness. This is dedicated to my queer and trans family.

_______________________________________ R REICHENBACH (she/her) is many things: a writer, a retired high jumper, a human fiercely committed to making the healthcare space safer for queer and trans patients, and an MS1 at the University of Arizona College of Medicine Phoenix.

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Title: Compassion Is a Tree: Respect for Human Dignity, Self-awareness, and Empathy This piece is inspired by my work in women’s health as a medical assistant, working closely with patients and hearing their stories.

_______________________________________ ALICE TREUTH is a clinical research coordinator with the University of Arizona College of Medicine –Phoenix with hopes of going to medical school.

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If compassion is a tree, then human dignity is the roots, self-awareness is the branches, and empathy is the leaves.

Of a tree, human dignity is the roots. Respect for human dignity must run deep throughout clinical practice, as roots run deep in soil. Without roots, a tree topples over; likewise, without respect for human dignity, clinical interactions sit precariously at the surface level. Without the respect for human dignity, one cannot recognize the gravity of clinical work. One cannot recognize that medicine, a means to address and improve health and well-being, is necessary because of the inherent value of life. Respect for human dignity deepens the interaction, bringing it beyond the surface to a level that acknowledges the intertwining moral, ethical, systematic, and social aspects of medicine. Compassion is rooted in the respect for human dignity.

Self-awareness is the branches. Just as branches grow because of the roots, self-awareness builds on the respect for human dignity by recognizing the provider’s role in the physician-patient interaction. Providers must practice self-awareness to acknowledge what they know and do not know. Physicians are not omnipresent, all-knowing beings. But, if physicians know what they do not know,

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they can collaborate with colleagues in their healthcare team who do know.

Furthermore, self-awareness should also be also cultural awareness. It means that providers recognize what identities they have and what they have experienced in their own lives; but more than that, providers must practice self-awareness to recognize what identities and experiences they do not have so that they can learn, listen, and appreciate all experiences and identities, especially those unlike their own. In this way, self-awareness leads to empathy, as branches lead to leaves.

Empathy is the leaves. Like leaves, empathy is the most visible part of the provider-patient encounter. It is what is felt. And emotions endure. Without empathy, words have meaning but not emotion. Empathy is not feeling for a patient, but is feeling with the patient. Commonly, leaves are often used to identify species of trees; leaves display the species of tree. Similarly, compassion is displayed through empathy to make patients feel recognized, seen and understood.

May we all have a deep respect for human dignity, a strong sense of self-awareness, and impressive empathy; may we all grow trees with deep roots, strong branches, and impressive leaves.

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Title: Honey in Progress My classmates and I joked that if it wasn’t for the pandemic and the transition to VITA for our application cycle, we would not have had such a wonderful, charismatic, and diverse set of incredible individuals. I feel so blessed to struggle through my medical journey with such magnificent people beside me. I hope I can stay in touch with them for my lifetime.

____________________________________________ NATALIE NABATY is a medical student from the class of 2025 at UACOMP with so many passions she struggles to juggle them all. Between playing guitar, dancing traditional Assyrian line dances, learning about global health, and serving the community, writing is a skill she is happy to refine while in medical school. When she’s not busy with her hobbies, work, and school, she enjoys spending time with her family and friends, exploring the world, and contemplating her existence.

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She is our little plant colony, Filled with pollen from flowers, Of many a state and county.

Colored with the cultures of ancient and new, Dressed in desire for betterment, At mandatories with our suits.

We fill her crevices with 120 bodies, The preceptors grin, As we complain about histology, What is that slide?

What is that image?

Its purples and pinks and, The micro flora constituting our visage.

One day we shall travel, along bluebells near and far, We won’t remember PBLs, Or the moments our souls felt marred, Our little wings will carry us, To new institutions and dreams, But our little homing device, Will lead us back to AZ. The little ants The little Bees Class of 2025 who made this homey colony.

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Title: Table 13 is in Bloom The resolution of anatomy lab resurfaced a myriad of emotions that I had pushed aside dealing with whenever I was focused on my tasks in lab. This short poem captures some of the thoughts I grappled with, questions I wish I could have asked my donor. I knew I wanted to capture some of my feelings in writing, especially since being a donor is something I might consider for my own passing.

_____________________________________________ NATALIE NABATY is a medical student from the class of 2025 at UACOMP with so many passions she struggles to juggle them all. Between playing guitar, dancing traditional Assyrian line dances, learning about global health, and serving the community, writing is a skill she is happy to refine while in medical school. When she’s not busy with her hobbies, work, and school, she enjoys spending time with her family and friends, exploring the world, and contemplating her existence.

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How many cups of coffee were downed?

How many champagnes toasted and cheered?

Did you ever stare at those uneven hands Marking the transition to another New Year?

How many cigarettes alighted, Embers illuminating an infinite night?

How many times had you fallen in love, With only ashes for company in time?

Did you question your imminent future?

Did you think the blueprints of my thoughts?

There are traces of you everywhere, In your history and amongst the spots, Marring constellations along skin, Enshrouded by the gifted textile of your post-life.

Three budding flowers occupying the space around Table 13.

Hands that resemble my grandmother’s, A body weathered through life.

You’ve guided me through, A lab session or twenty-two, While I trembled with the knife.

A fleeting nature, a taste, Of the questions the future will hold.

Your hand clasped in mine, In pursuit of meaning, with such limited time, This rite of passage for the blossoming physician.

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Title: The Wildflower My first year of medical school I drew a very similar piece to this, but redrawing it was under much different circumstances. I did my ICU rotation in a pediatric cardiovascular ICU. I took care of a baby girl and grew very close to her parents. On my last day, her mom told me they called her “The Wildflower” because wildflowers can grow in any conditions. Hers was the first patient funeral I have ever attended, and this piece of art helped me reflect on my time with her.

_______________________________ MERRION DAWSON is a fourth year medical student going into family medicine. In her free time she loves to paint, draw, listen to books on tape and spend time with her family.

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Title: Pieces Thinking about death is something we all do at various points in our lives. As a medical student, I found one such point for myself following our cadaver dissection lab associated with the first-year anatomy course. Donors have the option of leaving a note about themselves for the students to whom they would be assigned, but the donor assigned to my group chose not to do so. As such, following this intimate encounter, I was left to fill in the blanks.

_____________________________________ BRADY ANDERSON is a first year medical student at the University of Arizona College of Medicine-Phoenix. He is a husband, father, and probably should have been studying instead of writing poems.

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It feels hollow to have seen so much of you and know nothing about you to hold your heart in my hands and wonder who it loved To imagine what dreams you’ve realized the pain you’ve felt and the stories that are now yours alone Skin muscles nerves bones we analyzed you as pieces when you lived as a whole as more than the sum of your parts And I wonder if you’re really gone which you may be but not to me

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Title: Letting Go This piece was simply born out of a desire to create without judgment. I have spent a lot of time thinking about travesties in the world, grappling with COVID patients, and progressing through demanding medical education. I sometimes feel that my art has to reflect that perfectionism.

So, for this artwork, I let colors and style run the show.

There is no meaning other than the power of sometimes just having fun. I encourage the viewer to tap into the same space.

_____________________________________________ MEGAN CADIGAN is a fourth-year medical student pursuing Family Medicine. She has a long-standing love for the intersection between art and medicine and has used her artistic side as a guide for patient care as well as a form of stress relief throughout medical school. Her main mediums are drawing and painting (specifically acrylic) but would like to try her hand at oil painting and digital art.

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Title: Choice I wrote this piece about the summer I spent shadowing an OB/GYN who specialized in family planning, specifically in late-term pregnancy termination for fetal anomalies. My experience had a life-changing impact on my career goals and perspective on medicine. Some names and patient details have been changed in order to protect privacy.

_____________________________________________ BLAKE FELDMAR is a first-year medical student at the University of Arizona College of Medicine – Phoenix, where she serves as a co-leader of Medical Students for Choice. Born and raised in Los Angeles, she graduated from UC Berkeley with a degree in bioengineering in 2020. In her free time, she enjoys travel, scuba diving, musical theater, and spending time with friends and family.

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“Is this much blood loss normal for this procedure?” The anesthesiologist’s tone was concerned as he turned to Dr. Tanya Jones, the OB/GYN I was shadowing. Dr. Jones frowned and shook her head, efficiently placing more and more gauze pads into the patient in an attempt to staunch the flow of blood. Adrenaline coursed through my veins as I watched a seemingly infinite sea of red surge past the gauze, pouring onto the pristine ground and covering the tips of my plastic-coated shoes. Frustrated, Dr. Jones asked for someone to call down to the obstetrics floor immediately for better equipment. In the past, she had always been able to operate on the floor dedicated to her specialty, where nurses, OR technicians, and anesthesiologists were intimately familiar with gynecology and support was ready at her fingertips. However, the third floor had been growing increasingly busy, and Dr. Jones specialized in late-term pregnancy terminations — procedures which many deemed low priority for valuable space in the proper obstetrics setting. As a result, Dr. Jones had been relegated to operating on the seventh floor, which typically housed orthopedic surgeries. I watched in awe as Dr. Jones remained cool and confident, calmly instructing the various members of the surgical team until they were able to control the hemorrhage and complete the procedure.

That day was my first in an operating room, and the terrifying image of blood spilling onto the floor is one that will be seared into my memory forever. However, tied to it is a recognition of the weight of the decisions made by doctors in quick, irrevocable moments, and the heavy responsibility those decisions carry.

Throughout the next several weeks, I continued to shadow Dr. 27

Jones, following her not only through the operating room but to clinic appointments, Morbidity and Mortality reviews, and even to resident trainings. One afternoon, I accompanied her to a pre-op appointment for a young woman around my age.

“I can’t believe I let this happen,” the woman rolled her eyes and laughed self-deprecatingly, tucking her hair behind her ear. She spoke casually about college and sex, and exuded a poised self-assurance despite the potentially uncomfortable circumstances.

Heavily talkative, she reviewed her medical history as Dr. Jones prepared a speculum, and I sensed a shift in her tone as her words became more heated. “Y’know, I went to someone else about this before I came to you. This doctor was an old man, nice and all, but very traditional.” She proceeded to explain how he had spent upwards of an hour shaming her for her choice to end her pregnancy, bringing her lifestyle and values into question and eventually refusing to perform the procedure. Dr. Jones responded with overwhelming kindness, taking the woman’s hand before, apologizing that she’d had to go through such a traumatic experience to get here. Continuing to speak warmly, she reaffirmed that this choice had no bearing on the woman’s personal character, and that she had every right to make a decision that she thought was best for her future. To my surprise, the woman began to cry, a grateful smile visible behind her tears. “Thank you. I had no idea doctors could be so nice.” Her words shook me to my core; I was aware that lack of access to safe abortions was a huge issue worldwide and had heard many horror stories of similarly prejudiced doctors, but I always imagined them taking place somewhere far removed from myself and my bubble of likeminded friends and family. This interaction induced a radical shift in my 28

understanding of medicine — the need for compassion and genuine human connection was just as, if not more important than knowledge of physiology or chemistry.

This lesson was further mirrored in every patient I observed Dr. Jones interact with. While some patients were electing to undergo this procedure, for many others, this situation was agonizing. I was heartbroken for the 40-year-old woman whose IVF had finally succeeded, only for her baby to be diagnosed with a fatal brain condition, resulting in a recommended D&C. My chest ached for the woman who had traveled across the southern border to the US in order to receive better prenatal care, only to find that her twins had died in the womb. Every week, I was faced with unimaginable devastation, wrought upon a diverse array of patients each with a unique and deeply personal story. However, as I saw these women week after week — first for their pre-op appointment, then for their procedure, and later for their post-op follow-up — I noticed a near-miraculous trend. In their pre-op appointments, the patients were at some of their lowest moments, carrying heavy burdens visible in the droop of their shoulders or the crease of their brows. But at their post-op appointments two weeks later, while those weights were never completely gone, their load was always considerably lighter. The one thing these distinct patients all had in common was that, without fail, they returned with brighter eyes and bolder steps. I was blown away by the extraordinary strength of every woman who walked through the door, and the resilience they demonstrated in the face of unfathomable circumstances. Above all, I was struck by the compassion exhibited by doctors, the necessity of setting personal beliefs aside in order to preserve patient autonomy, and the deep impact of being able to share in one of the most intensely personal 29

decisions of a person’s life. My experience that summer simultaneously challenged and inspired me every day, and I am forever grateful for and humbled by the chance to further develop my understanding of the beautifully complicated nature of medicine, the impossible, intimate reality of decision-making, and the absolutely crucial right to choose.

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Title: Which one is the real medical emergency?

I recently met a patient in the hospital setting who was blind. I had no idea. When I took my time to gather her history and get to know her more, she told me I must have been new. When I asked how she could tell, she told me it because I was still too kind. The encounter has stuck with me; how we really don’t know the intricacies of our patients’ lives, or what they deal with on a day to day, especially in a hospital setting.

_____________________________________________ NATALIE NABATY is a medical student from the class of 2025 at UACOMP with so many passions she struggles to juggle them all. Between playing guitar, dancing traditional Assyrian line dances, learning about global health, and serving the community, writing is a skill she is happy to refine while in medical school. When she’s not busy with her hobbies, work, and school, she enjoys spending time with her family and friends, exploring the world, and contemplating her existence.

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Looking into your eyes staring blankly back, at me.

I wonder of your preoccupation, The worries you’re trying to see.

It’s nothing.

You’re complete blind, And I failed to perceive.

Hold your hand in mine, Let’s calm the winds tossing your tremulous mind At sea.

Expected tempos, DDx is A-fib with no memo, Appearing without history.

I’m worried about your heart, Not the poor rhythm it conducts, But its devastation from your blindness.

Heartbreak from how it stole your independence.

I feel all your despair, but now, I must leave you there, Until the next sound appears.

You say your heart, skips a beat.

Your pulse stutters in between – 33

Title: Health Equity Is and Is Not This piece is inspired by my background in sociology.

Equity is not providing each person with the same, but is recognizing the inequalities, socially-constructed, that contribute to health inequalities. At its core, social inequalities exist because not all lives are valued equally. It is a testament to the work that is being done and still needs to be done.

_______________________________________ ALICE TREUTH is a clinical research coordinator with the University of Arizona College of Medicine –Phoenix with hopes of going to medical school.

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Health equity is not the same healthcare for all.

Because some are more vulnerable.

Equity is recognizing and reconciling with the differences we have created.

Health equity is not the same Access Treatments Insurance Healthcare.

It is not having the same options.

Equity is not the same for all.

Because, all lives are not valued the same for all.

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Title: Melanin This image was captured at the height of the 2020 global Black Lives Matter protests in June. This was also pride month, a time for LGBTQ people to celebrate their diversity. Pride that year became about celebrating melanin of the BIPOC queer community, and I wanted to contribute to that movement. ___________________________________ MARCUS CHILDS is an MS2 at the UACOMP currently earning his dual degree in the MD/MPH program. He has a passion for serving and uplifting the underserved communities of all races, ethnicities, genders, and sexual orientations. He finds joy in creating symbolic images that incorporate medicine and humanity.

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Title: His Arms (and Hers) Are Outstretched Still This piece reveals the war of sexuality and spirituality. In this poem, the difficulty of coming to terms with one’s own sexuality (...and coming out of the closet) while also striving to feel spiritually fulfilled is made visible. Separating the world or societal stigmas and relying on yourself and the spirit you possess and cultivate is of the utmost importance in succeeding with this great task. This is based off of the authors true experience. _________________________________________ BAILEY ADAMS is a 20 year old woman who loves to be outdoors and exercise every muscle- creative and physical. Adams is an ambitious student who is graduating from her four-year university a year early with a BS in psychology. She is pursuing a masters degree and a PhD to become a psychologist. As a lesbian herself, Bailey wants to offer her services in particular to the LGBTQIA+ community in validation and positivity regarding their sexuality and place in their enviroments. She values her religious beliefs as a member of the Church of Jesus Christ of Latter Day Saints and wants to help people feel resolved and whole in every aspect.

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Words said without thinking- without considering who’s listening Spoken without even blinking as they preach a sinful christening An obtuse lack of understanding and an armed militia of defenses.

Grown so used to their own tight shoes, they don't know how to try on someone else's.

Judgment without compassion, imperfect justice without juvenile mercy, Somehow, they say I am wrong for my passion and my innocent love is ‘earthly’.

In a place where love one another is repeated until it loses meaning, I leave draped in my Sunday dress and comments that were ignorantly demeaning.

Somedays are harder than others- in this place where ‘all are welcome,’ I am stung and I have lost count of the many bleeding cuts I have from biting my tongue.

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My ears burn and my heart pounds… How blind does a ‘believer’ have to be?

My throat aches and my stomach flips- “they're talking about ME.” He gave sight unto the blind, so maybe he could help them see That on ancestry.com, there can be two adjacent circles on a family tree So forgive me if at times I am distant or withdrawn, it is hard to feel at home when I’m accused of living in Babylon.

Zion means “the pure of heart and intent”... that we as saints should possess such, Well, I fulfill those qualifications... even though I happen to prefer a woman’s touch I find peace in Christ my beloved savior- and I feel so loved when I pray.

But I can't ignore the undignified rage I feel when I hear the things people say 40

When the world is too much to handle and the big buildings we pray in feel loud, There is one who I find solace in- with a christ like love, she is endowed.

Her voice is like the softest hymn and her eyes give off the warmest light, The closest thing to heaven on earth is being all wrapped up in her so tight.

This person, this angel, this soulmate of mine who brings me closer to God Reminds me everyday through her love that we belong on this gospel sod.

She and i- we are here for the right reasons; to grow and to learn and to become To love and to cherish and to have and to hold in this intimately holy sanctum.

“Our father who art in heaven, hallowed be thy name.”

We know that you love us and our love- that in it, there's no shame.

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Doors we can't walk through hand in hand are doors I don't want to enter.

I know Zion is for the pure in heart, and for once, I am not a pretender.

I know the answers I have received- this is my knowledge, my testimony That I can still hold the iron rod while betrothed in sapphic matrimony To the woman I love so dearly... and I know God brought her to me.

Together: As we hold hands in sincere prayers- there's no place I’d rather be.

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Title: Welcome Sign This image was shot on a Fujifilm XT-20 (18-55 mm F 2.8 - 4) in Valparaiso, Chile.

When you’re queer, you learn to home in on signs of belonging and inclusion. I can’t think of a single symbol that evokes that homing desire more universally and more completely than the rainbow.

Even outside the United States, the rainbow has taken on this meaning, and wherever I go, its presence brings comfort and pride that I am around others who not only accept me but welcome me.

_____________________________________________ CATHERINE LOCKMILLER (she/her) is a Health Science Librarian and Diversity Fellow at Northern Arizona University. She prioritizes her work by focusing on health information literacy, analyzing the intersections between critical theory and librarianship, and most of all, providing a platform to discuss health inequities faced by transgender and gender diverse populations in the United States.

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Title: Who We Are Our life is influenced by so many different factors that truly shape who we are. We change over time due to different circumstances, different experiences, different necessities, and different desires. Reassessing who we are is important at each and every juncture of our lives in order to grow and develop.

________________________________________ DR. LISA R. SHAH-PATEL is the Director of Career and Professional Advising at the University of Arizona College of Medicine-Phoenix. She completed a seven-year combined Biomedical Sciences/Doctor of Medicine program and received her MD degree at the UCLA School of Medicine. She complete her radiology residency at St. Luke’s-Roosevelt Hospital in New York City, and her fellowship in Breast Imaging at the Mayo Clinic in Arizona. In her free time, she enjoys spending time with her family, going to the beach, skiing, and travelling.

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We are who we are From our genetics to our experiences We are who we are From our upbringing to our schooling We are who we are From our thoughts to our studies We are who we are From our beliefs to our fears We are who we are From our appearance to our core We are who we are From our communities to our relationships We are who we are From our desires to our dreams We are who we are

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Title: Dance as One This image was shot on a Fujifilm XT-20 (18-55 mm F 2.8 - 4) at the National Museum of the Arts in Santiago, Chile. It depicts dancers and musicians performing a traditional Chilean dance while a dog wanders among the performers. I am drawn to the physicality of the dancers as they hold difficult poses and move in unison to the many instrumental cues playing alongside them. I also find the intrusion of the dog to be evocative of the way that our most organized and carefully laid plans can be dramatically altered by a new — and sometimes joyful — visitor in our midst.

_____________________________________________ CATHERINE LOCKMILLER (she/her) is a Health Science Librarian and Diversity Fellow at Northern Arizona University. She prioritizes her work by focusing on health information literacy, analyzing the intersections between critical theory and librarianship, and most of all, providing a platform to discuss health inequities faced by transgender and gender diverse populations in the United States.

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Title: Spring Break Art: Reflections of Togetherness in the Era of Online Learning As the Class of 2024 worked through their first year of medical school during the COVID-19 pandemic, most of their learning took place online. The classroom became a collage of faces pieced together on Zoom – physically separate, yet brought together in a digital environment. Even online, the Class discovered (as all medical students must) the intense dedication and focus that is required to succeed in a medical curriculum. While it is an honor to learn the science and practice of medicine, students often disconnect from other hobbies, creative interests, and relationships while in school.

The combination of physical isolation and mental fatigue lead to a few questions: Where are students finding joy? When can students find time to recharge and reconnect to their interests outside of medical school? Where do we go (away from our desktops) to rest from the challenges of medical education? And what (or who) do we return to the classroom with afterwards? After nine months of learning online, the 50

Class of 2024 was invited to submit images or other media they connected with during their spring break. From their submissions emerged a series of digital collages. They include personal photographs, video clips, pieces of artwork, and quotations from movies and poems.

The final images were unplanned and created spontaneously.

My single objective was to incorporate media from every individual who volunteered to submit something (35 total students). These collages are reflections of togetherness in the era of online learning. They symbolize how our unique interests interact within a community – creating new perspectives and unexpected outcomes. Three of the collages are featured here, each accompanied by a short poem.

_____________________________________________ ERIK GARBER is a medical student in the Class of 2024 at the University of Arizona College of Medicine–Phoenix. He is interested in how self-expression and creativity are part of healing.

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Title: Love Galore

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Find somewhere quiet.

Break stones into Blocks and build your Sacred house.

Fill it all With colors And music.

Do it for fun.

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Title: I Came Here to Love You

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The top of a hike, Paintings, a poem, A day on the beach, Selfies with your favorite niece.

There are many Ways to love the world.

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Title: Forgiveness

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Forming a landscape Sharpened by self-cruelty I stop here, take off my shoes, And let the hot sand lay softly over my feet.

I forgive you.

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Title: Silence I wrote this piece about a patient I encountered at my Community Clinical Experience during my first semester of medical school. When faced with a very emotional situation, I simultaneously struggled with my desire to provide support, my feelings of inadequacy as a junior member of the health care team, and the necessity of remaining reserved and neutral when my natural reaction was an overwhelming urge to cry. I explored this experience in the following piece.

____________________________________________ BLAKE FELDMAR is a first-year medical student at the University of Arizona College of Medicine – Phoenix. Born and raised in Los Angeles, she graduated UC Berkeley with a degree in bioengineering in 2020. In her free time, she enjoys travel, scuba diving, musical theater, and spending time with friends and family.

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“There is no heartbeat.”

There’s an old riddle that asks, ‘What is the only thing so fragile that you break it simply by speaking its name?’

I am tempted to say it out loud now, “silence.”

To sound out the S and the I and the L and let the two syllables roll off my tongue.

But right now silence doesn’t feel fragile. It feels heavy, like a thick weighted blanket. It is covering the room, sucking the air out and leaving no oxygen left to breathe as it presses down on four and a half pairs of shoulders and lungs and ears.

“The baby is dead. You are miscarrying.”

The woman blinks once, twice, again. Her eyebrows furrow in confusion as she looks at the ultrasound screen, where her fetus is still visible.

The silence feels like a balm then, wrapping her in its tender embrace, persuading her to let it soothe her just a little longer, just a little longer —

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The silence does not break gently. It shatters with a wail, with hysterical sobs. The doctor and the nurse are now free of its shackles and they murmur quiet apologies, give embraces, repeat platitudes.

The silence does not leave me, though. I catch it as it flees, grab onto its tail feathers and latch on tight as it attempts to fly away. I keep it wrapped around me even as it flutters, struggling to break free from my iron grip. I keep holding it even as we leave the room, as the doctor discusses the next patient, as we move on to the next appointment.

She is my new companion, and she is louder than any noise I’ve ever heard.

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Title: the white walls My last few years before coming to Phoenix, I volunteered at the Utah State Hospital, a psychiatric inpatient facility.

My time there exposed me to the realities that face those suffering from mental illness, and the challenges of the professionals treating them. I interacted with many patients, some of which were new and adjusting to their new environment. Others had been there many years and considered the hospital their home. I’ll never forget the first time I saw the private living quarters. While the hospital was a very colorful and inviting place, the living quarters were simply comprised of a table, chair, and four white walls.

______________________________________ BRADY ANDERSON is a first year medical student at the University of Arizona College of Medicine-Phoenix. He is a husband, father, and probably should have been studying instead of writing poems.

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The white walls ask no questions they have no expectations they do not question the way you think or the things you hear or the way you feel they do not tell you that something is wrong with you they do not see you as a problem or a burden they do not judge or at least they keep it to themselves The white walls are there to hold you but can they contain you? they help you heal at least we hope they do they are the backdrop when you cry when you laugh when you scream they emphasize your shadow and make the pills look that much brighter

The white walls are predictable they do not move they do not change they remind you where to be and when to be there and how long you will be gone they will be there when you get back so will the bed and table that feel more and more like home for better or worse The white walls are numbing their blankness pierces and encompasses and helps you not to feel the fear confusion guilt and pain they quiet your mind and keep you still it is better that way or so we tell ourselves

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Title: Flocked Keepers A reflective piece written about the experience of supporting an individual through a mental health crisis.

The piece employs animal-based imagery to highlight the importance of community in navigating mental health challenges, specifically suicidal ideation.

______________________________________ ELLE MAUREEN NEWCOME is a former active travel leader and current internal medicine intern at University of Arizona, who enjoys creating as a way to unwind. She is passionate about addressing health disparities through medicine. In her free time, you can find Elle nordic skiing through her new neighborhood on rollerskis, spending time with friends and family, and of course, writing.

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This piece was originally published in our “Stories in Medicine” blog: https://storiesinmedicine.wixsite.com/uaphoenix

An ex told me she was having suicidal thoughts. In scrubs in the emergency department, I know how to handle this. Over FaceTime in pajamas, I do not.

My training as a medical student prepared me to ask calmly about ideation, intent, plan, and history. My experience as a human left me crying that night, tucked in a ball. The scales of my back curved and interlocked, armored, like an armored armadillo or potato bug. I heaved breaths like a 65

pug walking, trying to catch my thoughts, led on a leash by the unknown owner of day. Perhaps it is the postman. I do not let anyone touch my soft belly.

Together, we handled it well: she called emergency services. I picked up too many snacks — a KIND bar, peach rings, Pepsi — not sure if we’d be sitting in the emergency room for hours on end, a reflection of our fractured mental health infrastructure.

I wished I could pour that fizzing soda over the entire situation, letting the bubbled caffeination seep into her sadness and rejuvenate it with a lighthearted jolt. Instead, the deflated carbonation rolled off her oiled back like a duck, glistening. Her forest green sheened feathers are calm, unruffled, as her bright orange webbed feet of thought paddle frantically under the surface. I am an eel: charged, calm, and rolling with the waves that rock me, rippling in tandem down the parallel sides of my smooth body.

I left my video off through online lecture that week. In muted static, I echolocated my way through the course.

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Stalactites dripped in darkness around me. The cave felt cool, damp, reassuring. It held the stories of those who had navigated this situation before me, before her. I flap my delicate, gothic wings. They are so thin you see the blood vessels that course through them, steeling me with an eerie steadiness. I have been gripping upside down from my toes ever since. There is protocol for this, I tell myself. There is precedent.

I respect her autonomy; cages are not meant to protect humans.

We reached out to a network, our crew flocked together, geese headed north. Relinquishing my position as tip of the “V” felt simultaneously heavenly and purposeless. I live in suspended bliss between relief and the faltering that accompanies a change in vocation.

Honking, they flew on, and I settled into a new stillness, nestling near blanched weeds at the lagged edge of a quiet pond. I pull myself a bath that night and light a candle that smells like my childhood — Smucker’s chapstick and pink berries. The tears do not come until later. When they do, I release their saltiness into the warm water, sending freshwater minnows to sea. I hope they do ok, I pray. I hope she does ok.

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In the bath, my body glows with warmth, an orb of an angler fish dancing safely in front of its jagged jaws. Safe, but tethered. Tethered to its jagged jaws by a filament of connectedness.

It will be a long time before I roll over and expose my soft pug belly. The postman is here and my guard is up. I protect those around me fiercely, myself included. I bark at speculators, I bark at spectators, I bark at my shadow, I bark at the wind. I tell myself I am safe, and I do not yet fully believe it. I go to counseling. This week is not about me.

This story is not my story. This depression is not my depression. Yet we are interlinked, a network of beings whose journey implicitly impacts another.

My favorite legend about stars is that a Being throws a blanket over the earth, tucking in its winged, webbed, and wild inhabitants. To permeate the darkness, a hummingbird flies up to the blanket, poking holes for the light to shine through. I want to be that hummingbird for her, devotedly spiking pinpricks of light through the uncomforting, dark comforter. I have hummingbirds that flit me through this week, plethoric wings palpitating like a single beating heart. I wonder if the “V” of geese would 68

make the same delicate holes. Perhaps that is why Jupiter and Saturn overlapped this month: big goose holes in the sky.

To say this week was a zoo is an understatement. It was an exercise of triage, boundaries, and the calling all of keepers. It is a legend that is not about me. It is a legend that will repeat over and over and over again, as we are human and depression is universal. We are keepers of one another, and with this knowledge, we walk together through the hummingbird-dappled, goose-spackled night toward dawn.

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Title: Moon at Dusk When we live in times such as these, it’s always important to find that what centers you. This picture represents two of these: my roots and the light. Going back to my ranch roots regularly reminds me who I am and the basics of life: faith, family, life, death, food, water, and soil. I’ll get to a point that I just have to go get my hands dirty on the farm. The moon is light in the darkness, and it’s the same celestial being no matter where you are in the world. So when you’re lonely at night missing those important to you, remember to look up because they are looking at the same moon, too. It’s important that we all find those moments and experiences to ground us and give us perspective.

____________________________________ MELANIE CALDERWOOD is a Coordinator at the University of Arizona College of Medicine -- Phoenix with the Longitudinal Integrated Clerkship and three of the Certificates of Distinction: Rural Health, Service and Community Health, and Primary Care Scholars. She’s passionate about rural America. When she’s not enjoying the great food of the valley, she’s in Colorado at her sister’s farm playing with her nieces and nephews and the cows.

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1st Place Winning Photography, Amateur Category, The 2022 Employee On Our Own Time Art Exhibit University of Arizona

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Title: Clouds at Sunset

____________________________________ MELANIE CALDERWOOD is a Coordinator at the University of Arizona College of Medicine -Phoenix with the Longitudinal Integrated Clerkship and three of the Certificates of Distinction: Rural Health, Service and Community Health, and Primary Care Scholars.

She’s passionate about rural America. When she’s not enjoying the great food of the valley, she’s in Colorado at her sister’s farm playing with her nieces and nephews and the cows.

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Title: Morning Corn Every morning is a new day!

____________________________________ MELANIE CALDERWOOD is a Coordinator at the University of Arizona College of Medicine -Phoenix with the Longitudinal Integrated Clerkship and three of the Certificates of Distinction: Rural Health, Service and Community Health, and Primary Care Scholars. She’s passionate about rural America. When she’s not enjoying the great food of the valley, she’s in Colorado at her sister’s farm playing with her nieces and nephews and the cows.

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Title: The Physician’s Fix Adina’s motivation to study medicine grew as she continued to stand by her grandfather’s side as his dementia progressed. When her grandfather was diagnosed, she and her family struggled to grasp the reality that many neurodegenerative diseases have no cure. She was upset by the inevitable cognitive decline of a man who had prevailed through great hardships, such as surviving the Holocaust, now losing his strong personality, diminished to that of a child, to an unrelenting disease. Adina and her family continued to see how her grandfather’s love remained beyond all, but it has been an additional challenge for Adina as she entered the first year of her medical education to learn about the treatments that elongated her grandfather’s life, all while his dementia continues to progress. She explores the complex questions of what makes life meaningful, aging, and decline in her poem.

_____________________________________________ ADINA GREENE is a 1st year medical student at the University of Arizona College of Medicine-Phoenix. She attended UC Berkeley for her undergrad education where she cultivated her love for Classical Rome and Greek literature, poetry, and human behavior/ethics in addition to her academic passions of physiology and cognitive science. She is currently pursuing the Health Humanities Certification of Distinction at UA-COMP. 76

With a purposeful flick, The fire begins to burn.

The tall, white candles standing before me, Ignite with passion as the matches kiss the wick.

Their amber glow fills the home, As the black sky creeps across the windowsill.

Glasses overflowing with wine as red as blood— Bursts of laughter roar from the candlelight room— Reaching all corners of the home save one.

Idle in his corner lies an aged man, Eyes closed gently, white hair clinging flimsily on the leather chair.

As still as time.

An aroma of cinnamon overwhelms the room, As my grandmother’s cooking lines the table, The combination of scents creating a symphony of desire.

Our hazel eyes meet, As I deliver the old man’s dinner, Soft egg salad, mushed green beans, Whatever he doesn’t refuse to eat.

“Will you dance with me?” He says.

Hand outstretched.

A few chosen words From the mouth like a child.

An invitation.

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I can only imagine his mind is back in his youth, Far away from the empty grey walls of his bedridden state.

With a small nod, I push my stethoscope aside, And sense a firm grasp around my hands.

I squint against the sun.

As the rows of street vendors come into view— A myriad of colorful banners hang from the open-air market, A guitar plays softly in the background.

We are twirling.

I dip far down, My toe points up, almost touching the clouds.

Cradled by the man’s strong arms, I am confident I will not fall.

As we lock hands one last time.

All that is left Is the weak, brittle skin of a hollowed man.

The pool of wax continues to build, As the candles finish their marathon of light.

His doctors call him healthy.

They leave out the most important part of his medical story.

His treatments exacerbate depression of the mind.

A physician’s years of medical education, Hundreds of hours studying, But little lessons on courage— The courage to not fix someone who’s irreparably broken.

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Title: Vaccine When I saw the prompt about hope and relief this year, I think it was hard to not think about how the availability of the COVID vaccine has been the main source of hope for 2021 and 2022. It represents a return to normalcy.

However, with vaccine resistance and misinformation spread, it feels that the color has been drained from the hope of the vaccine. It is available and effective but requires the trust of patients to actually receive the vaccine. Therefore, I felt it was representative to have the painting be in black and white. It is hope, but not a perfect solution.

_____________________________________________ MEGAN CADIGAN is a fourth-year medical student pursuing Family Medicine. She has a long-standing love for the intersection between art and medicine and has used her artistic side as a guide for patient care as well as a form of stress relief throughout medical school. Her main mediums are drawing and painting (specifically acrylic) but would like to try her hand at oil painting and digital art.

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Title: taken Both of my paternal grandparents developed early onset Alzheimer’s disease, which they lived with until they passed away. I’m sure anyone who has been touched by this disease can relate to this haiku. Even while they are physically present, we miss the person who is taken from us.

_____________________________________ BRADY ANDERSON is a first year medical student at the University of Arizona College of Medicine-Phoenix. He is a husband, father, and probably should have been studying instead of writing poems.

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some plaques and tangles melted the person we love into memories

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Title: Home January 2022. Acrylic paint on canvas. Cerebral microvascular anatomy under a microscope. Evokes tree trunks and branches with fruit or flowers. In many ways, it represents home. Home for a dream, home for the inspiration of my mother’s art, newfound time for home-hobbies like art in the wake of COVID-19, home, which is both a place and a feeling.

The inspiration for this piece was my time on the neurosurgery service and the patients.

____________________________________________ DARA FARHADI is a fourth-year medical student at the University of Arizona College of Medicine – Phoenix. He graduated from The University of Arizona in 2016 with a degree in Neuroscience and Cognitive Science and then received a masters degree in Science Journalism from Boston University. He enjoys art museums, tennis, and video games.

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Title: Fi(nal)ve Hours I am daily called to give advice, but so often do not get to see what the result of my counsel yielded. I rotate off service or don’t get the follow-up text from a friend who had questions about how to care for a family member. In this instance my dear friend, Dr. Cheryl O’Malley, gave me a beautiful gift. She told me how a patient’s family was grateful for something I said. I encouraged them to keep their father awake during the day which gave them five hours with him; five hours they talked, laughed and cried. The final five hours that he would speak with them. In my gratefulness to her for telling me, I was inspired to write this. Time is precious and often we are blind to that fact. ____________________________________________ RUTH FRANKS SNEDECOR, MD is an inpatient teaching attending at Banner-University Medical Center Phoenix (B-UMCP). She is passionate about patient safety (PS) and quality improvement (QI) and works to find new and creative ways to integrate these concepts into the residents’ education as an Associate Program Director for the University of Arizona College of Medicine-Phoenix (UofAzCOM-P) Internal Medicine Residency and a Clinical Assistant Professor. She obtained her MD from the University of Arizona, College of Medicine, Tucson. She is board certified in Internal Medicine and is most proud of the residents and students she teaches to grow their skills as kind, thoughtful, and brilliant physicians caring for hospitalized patients.

Nationally recognized by the Alliance of Academic Internal Medicine and Society of Hospital Medicine (SHM) for her work in these areas; she is also on faculty for the Quality and Safety Educators Academy through SHM. A Phoenix Magazine “Toc Doc” this busy wife and mom of 3 (ages 14, 11, and 9 yo) you will often find her and her family on a mountain exploring the beauty of Arizona in their free time.

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I am in the business of time management.

I see what your body is telling me despite what your words say.

Your body was an hourglass and I was watching the sand fall.

The sparkle in your eyes and humor in your voice deceived your family.

I begged your sons to not let you sleep the day away.

When faced with the inevitable, we often look away from the clock.

But time is borrowed.

But time is of the essence.

But time and tide wait for no man.

They were holding you to the present, pushing against the black wall of delirium.

Forgiveness and memories were slow dancing at the edges of your final hours.

Anxious to be center stage.

Your sons kept you up all day.

You talked for five hours.

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Delirium waited in the dark space between sleep and wake, pain and comfort.

Delirium was jealous for your dignity and your sanity.

Delirium searched for you eager to consume your last hours.

They held you to the present; they pushed against the black wall of delirium.

Forgiveness and memories joyfully danced on the center stage of your final hours.

You died the next day.

I stole a single minute to counsel, not knowing that you would give them fi(nal)ve hours.

That you would say all that was left to say in 300 minutes, 18,000 seconds, 5 hours.

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Title: Inner Peace The inspiration behind the art piece entitled “Inner Peace” came from being at home thinking about all the constant movement and stresses around us. It’s important to reflect and take a moment to disconnect from the world and reconnect with a part of yourself that brings pure independent joy. It can spark up new creative approaches and confidence for one’s self because constant world repetition can sometimes mask needed self-reflections. I created “Inner Peace” using an Apple pen and an Adobe app called Fresco on my iPad Pro to combine multiple brush and coloring techniques.

____________________________________ ADOLPHO NAVARRO is is an award winning visual creative in the field of media production.

From a young age, his passion has been creating unique art in all forms including digital pieces and video production stories.

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Title: The Big Decision This was written the day our loved one decided he was ready to stop the ventilator that was keeping him alive.

___________________________________ DR. SUSAN KAIB is a board certified Family Medicine physician. She has been with the College of Medicine-Phoenix for over 11 years, and has experience in Doctoring, Case-Based Instruction, and Student Affairs. She has been selected for the Master Educator Award and the Gold Humanism Honor Society. She is a member of the American Academy of Family Physicians, and the chapter advisor for the Gold Humanism Honor Society.

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“I want to die today”. Written on the white paper with a fat marker. Written because his voice was gone and his diaphragm was too weak to keep pulling in air.

Completely aware, but unable to do much more than lift his hands to write and smile.

Compassion. Although we wanted more days together, he was done. Tired of the marathon he’d been running just trying to breathe. The feeding tube was removed.

Antibiotics and steroids stopped. Face-mask ventilator changed to bring oxygen through a small tube to his nose.

What a lovely face to finally be able to see again.

Smile. He is a bright light to anyone who he meets. He can still find joy in our conversations and share his heartwarming smile. An RN for forty years, he’s seen his share of death from the other side of the bed. Now, it’s his bed. The amyotrophic lateral sclerosis (ALS), is taking him too fast. It’s only been a year.

Love. Three hospital visitors for end of life. He loves people. His wife sat with him every day. But today, she held his phone for video calls with family in Australia. She read emails streaming in from loved ones across the world.

We smiled, laughed and cried.

Ice chips. Freedom. That’s what he calls them. Nothing by mouth for days due to aspiration risk. But now as many ice chips as he wants.

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Fear. What is the biggest decision you’ve ever made? “Do I die today”? Terrifying. The last decision, ever. You don’t want to get it wrong. He wasn’t sure. “Bipap” he mouthed, making a mask-like shape with his hand for his non-invasive ventilator. One more day with loved ones.

Time. There will never be enough. We were happy to have another two days together. Don’t rush the last moments.

And now he’s truly ready. But are we?

Appreciation. Thank you to his ICU team for allowing Patrick to be in charge of his life…and his death.

Patrick McCartan Feb. 13, 1954-Feb.5, 2022

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Title: Tree The inspiration for this poem was from my recent trip to Hawaii when I was able to take this picture at Waikiki Beach. The vast beauty of nature contradicted with the difficult times experienced by all those across the world today truly reinforces the notion that we all must come together as one.

_______________________________________ DR. LISA R. SHAH-PATEL is the Director of Career and Professional Advising at the University of Arizona College of Medicine-Phoenix. She completed a seven-year combined Biomedical Sciences/Doctor of Medicine program and received her MD degree at the UCLA School of Medicine.

She complete her radiology residency at St. Luke’s-Roosevelt Hospital in New York City, and her fellowship in Breast Imaging at the Mayo Clinic in Arizona. In her free time, she enjoys spending time with her family, going to the beach, skiing, and travelling.

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Canopy built, shade created Broad and tough, from roots to branches Not one trunk but many together Creating strength and beauty all in one Virus came, interfered with life Strong and resilient, from delta to omicron Not a single variant but many together Creating havoc and sadness all in one Green and vibrant, branches and beauty Glimpses of sunlight, shadows portrayed Lives within, from birds to critters Divine beauty and glistening vastness all in one Ugly and pokey, stubborn and hardy From shortness of breath to intubations, lives taken Silence within, from vaccine to booster Death resulting and sadness ensuing all in one

Time to fight, time to heal Come together as one Each different leaf, each different branch Robust together, knowing together we fight all in one 97

Title: Resolution In Response to the Call for Submissions theme on “Resolution,” I paused and reflected on the things, the events and lives that were affected globally and narrowed it down to the core of my own experience. I thought to form an acronym to convey my thoughts that we can proceed with God’s grace to act in a resolute way to preserve our wellness.

_______________________________________ DR. JOAN FRANCES C. CHUA is a Board-Certified Internist, currently a Part-Time Faculty at the UA COMPhoenix, Doctoring Program as a Clinical Skills Evaluator and holds a Clinical Assistant Professor title in Internal Medicine. She completed her Internal Medicine Residency Program at St. Francis Medical Center in Pittsburgh, Pennsylvania. Her Rotating Internship was completed at Santo Tomas University Hospital in Manila, Philippines.

She earned her degree in Doctor of Medicine and Surgery at the University of Santo Tomas in Manila, Philippines.

She completed her undergraduate degree in Bachelor of Science, Major in Biology, Accelerated 3-year Program at the University of Santo Tomas as well.

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Reflecting on God’s blessings and grace Enables us to recover balance.

Smiling often is fuel to uplift the spirit, Opening a prayer as well, for goodness of fit.

Lofting our goals facilitates hope and love.

Unifying our intentions to move and explore, Tools and new skills, we learn to use to cope.

Innovating we do, to be inspired to inspire.

Offering support for others, as we discern, Navigating our uncertainties with faith.

Awareness will abase fear to secure health.

Connect and consider one’s roles, To tread to safety as we abide by the rules, directing us to preserve our wellness.

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Title: Tidal Joy This image was shot on a Pixel 4A at the Kalalau Trail in Kauai. After what felt like years of isolation and indoors living, the chance to be outside and in the presence of fresh air, roaring tides, gloomy caverns, and crystal sand, was like entering an entirely new world. The figure in the image represents the sheer, unrestrained joy of being totally present in that new world.

__________________________________________ CATHERINE LOCKMILLER (she/her) is a Health Science Librarian and Diversity Fellow at Northern Arizona University. She prioritizes her work by focusing on health information literacy, analyzing the intersections between critical theory and librarianship, and most of all, providing a platform to discuss health inequities faced by transgender and gender diverse populations in the United States.

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